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Apr 3

Intermittent fasting should first be discussed with your doctor – KPCnews.com

It seems like there are endless ads to convince us to buy a piece of equipment or a food supplement or enroll in a program to make us lose weight. But in reality, we just need to figure out how to burn more calories than we consume.

To that end, a new review of 21 studies suggests possible health benefits of intermittent fasting. Their findings suggest that fasting might be effective for mild to moderate weight loss for certain groups of people, at least in the short term.

They also indicate that it is a myth that people are going to feel weak and not be able to concentrate during fasting. In fact, they may actually have a better ability to concentrate.

The trials so far have only been conducted in adults who are generally overweight or obese and sometimes have high blood pressure, dyslipidemia, and/or diabetes. But some have been performed in subjects with normal weight.

Even though they may benefit from weight loss, those with medical conditions including diabetes or patients who need to take medications with meals at certain times of the day should seek clinical supervision when considering intermittent fasting.

Based on existing evidence, intermittent fasting should not be done by children under age 12 and those who have a history of an eating disorder or a body mass index (BMI) of less than 18.5.

Opinions vary about the safety of fasting in teens with obesity, even when supervised.

Also, safety has not been evaluated in those older than age 70, and in women who are pregnant or breast feeding.

Despite the recent surge in the popularity of intermittent fasting, only a few studies have examined the health benefits of these diets in humans.

The researchers identified 21 clinical trials of three types of intermittent fasting strategies:

Alternate day fasting (alternating between consuming 0-500 Calories on fasting days, followed by unlimited food on feasting days), six trials.

5:2 diet (feasting on 5 days and fasting on 2 days), seven trials.

Time-restricted eating (eating during a 4- to 8- hour window), nine trials.

The trials were short (mostly 5-12 weeks long) and small (10-150 participants), and mostly conducted in the U.S.

They found these strategies can all produce a mild to moderate weight loss of up to 8% during trials of 8-12 weeks, similar to that attained with a calorie-restricted diet.

Some studies found that patients had improvements in blood pressure, LDL cholesterol, triglycerides, insulin resistance, and hemoglobin A1c (a measure of blood sugar control).

These weight-loss strategies produced few gastrointestinal, neurological, hormonal, or metabolic adverse side effects.

The researchers noted that one or two weeks of adjustment is typically needed when individuals start intermittent fasting.

While following this eating pattern, patients should be encouraged to consume plenty of fruits, vegetables, and whole grains to boost their fiber and micronutrient intake.

On fasting days, they should consume at least two ounces of lean protein to help control hunger and prevent excessive loss of lean mass. On those days, alcohol is permitted but not recommended. Energy drinks and coffee or tea without sugar, milk, or cream are allowed, and diet soda should be limited to two servings a day because it can increase sugar cravings.

Ideally, people should be followed by a healthcare provider for adverse effects, especially during the first three months of intermittent fasting. Dieters should be monitored for deficiencies in vitamin D, vitamin B12, and electrolytes (salts in the blood stream), as well as for changes in medications for blood pressure, lipids, and glucose that may need to be adjusted if patients lose weight.

Patients who reach their weight-loss goals and wish to stop intermittent fasting need to transition to a weight-maintenance program, possibly by increasing energy intake on fasting days to 1,000-1,200 Calories per day or widening the eating window to 12 hours in time-restricted eating.

While this research is encouraging for those who find this sort of diet more acceptable than other weight control programs, much longer-term studies are needed on issues such as safety and in broader demographics.

Personally, I have found limited success in the past with fasting, especially when members of my household and I have become hangry, a condition that seemed to improve after eating something.

But if you want to try out one of the intermittent fasting patterns described above, it would be wise to discuss it with your healthcare provider first.

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Intermittent fasting should first be discussed with your doctor - KPCnews.com

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